ERICKA TIDMORE TRAVERS (NPI# 1124663695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124663695 |
| Entity Type | Individual |
| Full Name | ERICKA TIDMORE TRAVERS |
| Other Name | ERICKA MICHELLE TIDMORE |
| Credential | CADC |
| Practice Address |
40 Summer St Unit 4 Bangor ME 04401-7144 |
| Mailing Address |
588 Veterans Hwy Brooks ME 04921-3908 |
| Practice Telephone | 2075731266 |
| Practice Fax Number | 2073525511 |
| Mailing Telephone | 2075617269 |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2019-11-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CAC6941 | ME | Behavioral Health & Social Service Providers |
| Street Address |
40 SUMMER ST UNIT 4 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-7144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002750 | Alyssa Paige Oliver | Counselor | 689 Odlin Rd, Bangor, ME 04401-6709 | 2020-08-05 |
| 1699310169 | Jessica Coleman | Counselor | 40 Summer St Ste 4, Bangor, ME 04401-7144 | 2019-11-08 |
| 1194368159 | Olena Kenney | Counselor | 689 Odlin Rd Ste 1, Bangor, ME 04401-6709 | 2019-10-23 |
| 1437719721 | Christina Dawn Levesque | Counselor | 319 State Street, Bangor, ME 04401-0440 | 2019-06-18 |
| 1023516275 | Michelle Crate | Counselor | 27 State St Ste 51, Bangor, ME 04401-5113 | 2018-01-23 |
| 1619346400 | Angela Mcquate | Counselor | 304 Hancock St Ste 2h, Bangor, ME 04401-6573 | 2015-09-22 |
| 1760703870 | Sarah J Falvey | Counselor | 98 Cumberland St, Bangor, ME 04401-5234 | 2010-06-14 |
| 1043404544 | Harry Eli Barron | Counselor | 74 Dowd Rd, Bangor, ME 04401-6700 | 2007-08-29 |
| 1962575787 | Laura Levenson | Counselor | 73 Pine Street, Bangor, ME 04401 | 2006-11-17 |
| 1285710541 | Gordana Hassett | Counselor | 31 Central St, Suite 216, Bangor, ME 04401-5145 | 2006-10-30 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.